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Michigan - Employer suddenly has STD tenure AFTER my claim

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  • Michigan - Employer suddenly has STD tenure AFTER my claim

    I live in Michigan and have worked for this company 10 months.

    Recently I discovered I needed a serious back surgery that would leave me unable to work for several months. Now I read my benefit details umpteen times and I took the time to call my benefit provider to run though my scenario to ensure I understood what and how my STD benefits would take effect.

    I filled out the required paperwork a week before my operation - including detailed information from my health care provider which included estimated time off, my diagnosis, the type of operation I was having etc.

    So I don't hear anything back - I decide to check in with corporate to make sure nothing else is needed by me - they claim they never received the paperwork (which I have proof of the health care provider faxing them). So I have them re-fax it and since I had a copy I re-faxed it myself too. I'm told the day before my surgery everything is all set. While I'm in the hospital recovery my wife receives a letter from my employer stating my return to work date (which is only 3 weeks out). Which my doctor recommended 4 months.

    So while in the hospital I call them to clarify what I thought was a mistake. Turns out my employer claims there is a tenure now for STD and I only qualify for 3 weeks of STD. I was also told I don't qualify for FMLA either.

    I don't know what to do - I don't have my first checkup until 6 weeks out (same time I was told to not drive) yet my employer expects me return to work in half that time. It also sounds like in MI you can't qualify for FMLA until you've worked there for 12 mos.

    Never have I heard or read about a tenure for STD now suddenly my employer is claiming there is one.

  • #2
    If you have only worked for the company for ten months, then they are correct that you do not qualify for FMLA. FMLA eligiblity is set by Federal law and one of the four criteria, ALL of which must be met, is that you have worked for the employer for a minimum of 12 months. It''s not just Michigan - it's everywhere in the US.

    Whether there is or is not a tenure for the STD policy is a feature of the policy itself. Some policies have them; some do not. It's a very black and white issue; if there is one mentioned in the policy and you have not met it, then it doesn't matter what your employer may or may not have said; you are not eligible for benefits, period. Likewise if there is not one, then AS LONG AS your illness or injury is otherwise qualified under the policy, then you are.

    You are entitled to a copy of the plan document of the policy on request. Ask for one and read it. Whatever is in the plan document is carved in stone. If the plan document says you have to have worked there for a year to be eligible (or whatever) then it doesn't matter if your employer never told you about it and it doesn't matter even if they told you, you would be eligible; you're not. If the plan document makes no mention of a tenure, then you are free to submit your claim. The plan document rules.

    FYI, STD benefits are NOT leave; they are how you get paid while you are on leave. Additionally, outside of FMLA, STD benefits do not provide any kind of job protection. Not your question, I know, but important information to have nonetheless.
    Last edited by cbg; 08-27-2011, 02:16 PM.
    The above answer, whatever it is, assumes that no legally binding and enforceable contract or CBA says otherwise. If it does, then the terms of the contract or CBA apply.

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    • #3
      Thank you for the reply. I am waiting on them to send me some sort of documentation outlining the policy. Again I read thru what was given to me at time of hire along with any online resources they have regarding benefits and tenure was never mentioned previously.

      On another note is there any mandate / law that says they have to reply to you within X amount of days for approval / denials?

      Heres my big issue. Ok I can live with the tenure thing but they really did a "F" job on me telling me that AFTER the fact. I believe I went out of my way to get informed about the benefits and policies ahead of time and if I needed 12 months of tenure I could have waited 2 more months to have my operation and not be in this bind.

      They had all the information they should have needed one week prior to my surgery but I didn't receive their reply until almost a week after my operation.

      Thanks again for the info.

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      • #4
        No there isn't a time frame. Your employer doesn't have to assume your surgery is something that can be scheduled at any old time. If an employee comes to me and says they need back surgery, I'm not goingto second guess that need and suggest they wait.

        Did you actually talk to your supervisor or HR about how long you needed to be off work? What did they say? Many employers will grant leave for those who do not qualify for FMLA but how much leave they grant and if there is any paid leave feature available are totally up to company policy. The law doesn't specify what must be offered.
        I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

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